12 Drugs Commonly Prescribed for Depression
Depression—or major depressive disorder—is a mood disorder. It is one of the most common mood disorders in the United States. Symptoms can be disabling and include long-term feelings of sadness, guilt or despair. People with depression may lose interest in daily activities. They can experience anxiety, sleep problems, and suicidal thoughts. Experts do not fully understand how depression develops. Genes, brain chemicals, stress, and other environmental factors likely play a role.
Depression treatment has two main components. The first one is talk therapy—or psychotherapy. It promotes healthier ways to think, behave and cope. The second part is using medications to manage symptoms. Combining talk therapy with medicine for depression often provides the best results.
Classes of Depression Medications
Doctors follow expert guidelines when diagnosing and managing depression. There are two main types of drugs doctors prescribe to treat depression:
- Antidepressants. These drugs work by balancing brain chemicals that are involved in depression. There are various classes of antidepressants; the different classes influence different chemicals. As a result, the side effects of antidepressants can vary.
- Add-on therapy. These drugs augment treatment with antidepressants. There are a few types of add-on therapy medicines. This includes a second antidepressant, thyroid hormone, and other medicines with effects on mood and anxiety.
Many people see improvement in some symptoms soon after starting an antidepressant. However, it can take a few weeks to see the full effects of these medications. It is important to give antidepressants some time to work. If you do not see progress after four weeks, talk with your doctor. It may be necessary to adjust the dose or switch medicines.
Like symptoms, side effects from antidepressants may improve or go away within a few weeks of starting. However, you should contact your doctor for severe side effects or side effects that continue after 2 to 4 weeks.
Common Depression Medications
Your doctor has many options when selecting an antidepressant. Your other medical conditions and the possible side effects of the drug are considerations. If you have used an antidepressant in the past, your doctor will also take into account your response to it. Finding the right treatment for you may involve some trial and error.
Here are 12 drugs commonly prescribed for depression:
- Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, and others) is what’s called an atypical antidepressant. This means it doesn’t quite fit into any of the main categories of antidepressants. Side effects include dry mouth, nausea, and restlessness. How often you take it depends on what form of the medicine you use.
- Citalopram (Celexa) is an SSRI (selective serotonin reuptake inhibitor). SSRIs increase the amount of serotonin in the brain. This type of antidepressant usually has fewer side effects than other kinds. However, some people have a decrease in their sex drive or ability. Citalopram comes as a tablet and a liquid you take once a day.
- Duloxetine (Cymbalta) is an SNRI (serotonin and norepinephrine reuptake inhibitor). SRNIs increase both serotonin and norepinephrine in the brain. Like SSRIs, this class usually has milder side effects. SNRIs can also help with some types of pain. Duloxetine is an extended-release capsule you take once or twice a day.
- Escitalopram (Lexapro) is also an SSRI. It is available as a tablet and a liquid. You usually take it once daily. Side effects are similar to other SSRIs.
- Fluoxetine (Prozac) is another SSRI. It comes as a capsule, tablet, a delayed-release capsule, and a liquid. The delayed-release capsule has once weekly dosing. The other forms are usually once daily. Make sure you know how to take your specific form. Common side effects include restlessness and decreased appetite.
- Paroxetine (Paxil, Paxil CR) is an SSRI. All dosage forms usually have once daily dosing. Taking it with food can decrease stomach upset.
- Sertraline (Zoloft) is an SSRI that comes as a tablet and a liquid. The usual dose is once daily. Stomach upset and restlessness are common side effects. Sexual difficulties are also possible.
- Trazodone (Desyrel, Oleptro) is an atypical antidepressant. You usually take the regular tablet twice a day with a meal. You usually take the extended-release tablet on an empty stomach at bedtime. Trazodone can cause sleepiness, which can help if you have trouble sleeping.
- Venlafaxine (Effexor, Effexor XR) is another SNRI. You take both the tablet and the extended-release capsule with food. Stomach upset, headache, and appetite loss are common side effects.
- Vortioxetine (Trintellix) is a serotonin modulator. It is considered a mix-acting drug. It works like an SSRI, but it also directly stimulates serotonin receptors. This means it may work when an SSRI has failed. It is available as a tablet for once daily dosing. You can take it with or without food. The most common side effects are nausea, vomiting and constipation.
- Brexpiprazole (Rexulti) is an atypical antipsychotic. It is add-on therapy when depressive symptoms persist on an antidepressant. It comes as a tablet you take once daily. You can take this drug with or without food. Common side effects include headache, fatigue and constipation.
- Quetiapine (Seroquel, Seroquel XR) is also an atypical antipsychotic. It is an add-on therapy that comes as a tablet and an extended-release tablet. Common side effects include dizziness, sleepiness, constipation and headache.
Doctors have several other medications available for treating depression. If you are experiencing persistent side effects or feel your medication is not improving your symptoms, talk with your doctor. It may be possible to try a different medicine and get better results. Don’t stop taking your antidepressant without talking with your doctor first. It may be necessary to wean off the drug or taper your dose.
The goal of treatment is to achieve remission of depressive symptoms. Your doctor may recommend continuing treatment for up to a year. However, some people take medication for even longer and continue to see benefits.